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Demand and substitution effects of e...

Barresi, Barry Joseph.

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Demand and substitution effects of expanding Medicare coverage to optometrists.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Demand and substitution effects of expanding Medicare coverage to optometrists./
Author:	Barresi, Barry Joseph.
Description:	163 p.
Notes:	Source: Dissertation Abstracts International, Volume: 53-10, Section: A, page: 3670.
Contained By:	Dissertation Abstracts International53-10A.
Subject:	Economics, General. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=9306838

Demand and substitution effects of expanding Medicare coverage to optometrists.
Barresi, Barry Joseph.

Demand and substitution effects of expanding Medicare coverage to optometrists. - 163 p.

Source: Dissertation Abstracts International, Volume: 53-10, Section: A, page: 3670.

Thesis (Ph.D.)--New York University, 1992.

Using Medicare claims data from the period of 1985 to 1989, a pooled time series design study estimated the impact of two policies on the level and provider share of demand for office based eye care. The policies of interest were (a) a provision of the 1986 Omnibus Reconciliation Act which redefined the extent of participation in Medicare by optometrists and (b) the enactment of optometry therapeutic drug prescriptive authority (TPA) laws. Before the Optometry Medicare Amendment, optometrists could only receive Medicare reimbursement for services to the aphakic (post cataract) patient. Effective April 1, 1987, this limitation was lifted. Henceforth, optometrists were authorized for Medicare reimbursement for all covered services permissible under state laws or regulation. TPA laws expand the statutory scope of optometric services by permitting use of pharmaceutical agents to treat diseases of the eye. A fixed effect model tested a theory of insurance coverage expansion that predicted how the Medicare Amendment affects consumer choice and how optometry therapeutic drug prescriptive authority (TPA) laws redefine the supply of eye care providers. The Medicare Optometry Amendment stimulates the quantity of eye care demanded at both the primary and secondary care level. Optometrists gained significant increases in market share as compared to ophthalmologists. Supplier induced demand occurs when substitutability is enhanced by the introduction of therapeutic drug prescriptive authority laws (TPA). Expanding insurance coverage in the Medicare Program potentiated the impact of TPA related increases in overall demand and shifts market share from ophthalmologists to optometrists. The role of TPA laws must be considered in developing strategies to contain costs through fee controls and utilization management. In forecasting Medicare demand and expenditures, the Health Care Financing Administration and other agencies should consider the impact of changes in optometry's statutory authority by including TPA laws in specifications of any eye care demand and expenditure models. Moreover, the time trends of more states enacting new TPA laws or further expanding existing TPA laws are relevant to consider in any policy analysis of eye care in the Medicare Program.Subjects--Topical Terms:

1017424
Economics, General.

Demand and substitution effects of expanding Medicare coverage to optometrists.
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245 1 0 $a Demand and substitution effects of expanding Medicare coverage to optometrists.
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500 $a Source: Dissertation Abstracts International, Volume: 53-10, Section: A, page: 3670.
502 $a Thesis (Ph.D.)--New York University, 1992.
520 $a Using Medicare claims data from the period of 1985 to 1989, a pooled time series design study estimated the impact of two policies on the level and provider share of demand for office based eye care. The policies of interest were (a) a provision of the 1986 Omnibus Reconciliation Act which redefined the extent of participation in Medicare by optometrists and (b) the enactment of optometry therapeutic drug prescriptive authority (TPA) laws. Before the Optometry Medicare Amendment, optometrists could only receive Medicare reimbursement for services to the aphakic (post cataract) patient. Effective April 1, 1987, this limitation was lifted. Henceforth, optometrists were authorized for Medicare reimbursement for all covered services permissible under state laws or regulation. TPA laws expand the statutory scope of optometric services by permitting use of pharmaceutical agents to treat diseases of the eye. A fixed effect model tested a theory of insurance coverage expansion that predicted how the Medicare Amendment affects consumer choice and how optometry therapeutic drug prescriptive authority (TPA) laws redefine the supply of eye care providers. The Medicare Optometry Amendment stimulates the quantity of eye care demanded at both the primary and secondary care level. Optometrists gained significant increases in market share as compared to ophthalmologists. Supplier induced demand occurs when substitutability is enhanced by the introduction of therapeutic drug prescriptive authority laws (TPA). Expanding insurance coverage in the Medicare Program potentiated the impact of TPA related increases in overall demand and shifts market share from ophthalmologists to optometrists. The role of TPA laws must be considered in developing strategies to contain costs through fee controls and utilization management. In forecasting Medicare demand and expenditures, the Health Care Financing Administration and other agencies should consider the impact of changes in optometry's statutory authority by including TPA laws in specifications of any eye care demand and expenditure models. Moreover, the time trends of more states enacting new TPA laws or further expanding existing TPA laws are relevant to consider in any policy analysis of eye care in the Medicare Program.
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650 4 $a Health Sciences, Ophthalmology. $3 1019445
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